"Better Deaths Than Any I've Ever Seen"

There are only a couple things I pray regarding the end of my life. One of them is that I will die well. By that, I mean that if I have any advance warning of my impending earthly demise, I desire to die in faith, confidence, trust, and peace, not "like the rest of men, who have no hope" (1 Thess. 4.13). I want to honor God not just in how I live my life, but also in how I "live" my death.

If it's a protracted death, Iwould love for it to be something like what's described in today's New York Times. The story profiles nuns at a convent and the provisions they've made for each other to die among friends, with dignity, in an environment of hope. Here are some excerpts:

July 9, 2009
Months to Live
Sisters Face Death With Dignity and Reverence
By JANE GROSS
PITTSFORD, N.Y. —
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A convent is a world apart, unduplicable. But the Sisters of St. Joseph, a congregation in this Rochester suburb, animate many factors that studies say contribute to successful aging and a gentle death — none of which require this special setting. These include a large social network, intellectual stimulation, continued engagement in life and spiritual beliefs, as well as health care guided by the less-is-more principles of palliative and hospice care — trends that are moving from the fringes to the mainstream.

For the elderly and infirm Roman Catholic sisters here, all of this takes place in a Mother House designed like a secular retirement community for a congregation that is literally dying off, like so many religious orders. On average, one sister dies each month, right here, not in the hospital, because few choose aggressive medical intervention at the end of life, although they are welcome to it if they want.

“We approach our living and our dying in the same way, with discernment,” said Sister Mary Lou Mitchell, the congregation president. “Maybe this is one of the messages we can send to society, by modeling it.”

Primary care for most of the ailing sisters is provided by Dr. Robert C. McCann, a geriatrician at the University of Rochester, who says that through a combination of philosophy and happenstance, “they have better deaths than any I’ve ever seen.”
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“It is much easier to guide people to better choices here than in a hospital,” he said, “and you don’t get a lot of pushback when you suggest that more treatment is not better treatment.”
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Few sisters opt for major surgery, high-tech diagnostic tests or life-sustaining machinery. And nobody can remember the last time anyone died in a hospital, which was one of the goals in selling the old Mother House, with its tumbledown infirmary…and using the money to finance a new facility appropriate for end-of-life care.

“There is a time to die and a way to do that with reverence,” said Sister Mary Lou, 56, a former nurse. “Hospitals should not be meccas for dying. Dying belongs at home, in the community. We built this place with that in mind.”

….Here, everyone mixes. Of the 150 residents, nearly half live in the west wing, designated for independent living….Forty sisters live in assisted-living studios, and another 40 in the nursing home and Alzheimer’s unit, all in the east wing, with the chapel, dining rooms and library at the central intersection. Closed-circuit television allows those confined to their rooms to watch daily religious services.
….
Dr. McCann said that the sisters’ religious faith insulated them from existential suffering — the “Why me?” refrain commonly heard among those without a belief in an afterlife. Absent that anxiety and fear, Dr. McCann said, there is less pain, less depression, and thus the sisters require only one-third the amount of narcotics he uses to manage end-of-life symptoms among hospitalized patients.

On recent rounds, Dr. McCann saw …Sister Jamesine Riley, 75, once the president of the congregation, who barely survived a car accident that left her with a brain injury, dozens of broken bones and pneumonia. “You’re not giving up, are you?” Dr. McCann asked her. “No, I’m discouraged, but I’m not giving up,” Sister Jamesine replied in a strong voice.
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Some days, Dr. McCann said, he arrives with his “head spinning,” from hospitals and intensive-care units where death can be tortured, impersonal and wastefully expensive, only to find himself in a “different world where it’s really possible to focus on what’s important for people” and, he adds, “what’s exportable, what we can learn from an ideal environment like this.”
….
Barbara Cocilova, the nurse practitioner here, sees differences in the health of these sisters compared with elderly patients in other settings….Among those with Alzheimer’s, Ms. Cocilova said, diagnostic tests tend to produce better-than-expected results among those who are further along in the disease process, a possible result of mental stimulation.
….
Sister Bernadine Frieda, 91, spry and sharp, spends her days visiting the infirm with Sister Marie Kellner, 77, both of them onetime science teachers. Sister Marie, who left the classroom because of multiple sclerosis, reminds an astounded sister with Alzheimer’s that she was once a high school principal (“I was?!”) and sings “Peace Is Like a River” to the dying. “We don’t let anyone go alone on the last journey,” Sister Marie said.

Seven priests moved here in old age, paying their own way, as does Father Shannon, who presides over funerals that are more about the celebratory “alleluia” than the glum “De Profundis.”…He shares with them the security of knowing he will not die among strangers who have nothing in common but age and infirmity.

“This is what our culture, our society, is starved for, to be rich in relationships,” Sister Mary Lou said. “This is what everyone should have.”

I've often criticized the Times for cluelessness on religious matters. This article is a notable exeption. You can read the entire thing here.

And click here for a short audio slideshow about the sisters and their home. It's excellent.

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(In case you're wondering, my health is fine, as far as I know. There are no veiled messages in this blog post!)

Memento Mori*

Well, if one post on death was good, won't two be better?

I came across this quotation from Becoming Real, by Steven James. I haven't seen the book and can't vouch for it, but I find the following to be well-expressed:

Everyone dies in the midst of something. People die in the midst of going to the dentist's office or driving home from vacation or taking a shower or watching TV or mowing the lawn or barbequing ribs on the back deck or enjoying a good night's sleep. People die in the midst of arguments, grudges, dreams, plans, careers, headaches, heartaches, and courtships. People die in the midst of marriage and puberty and old age. Some die in the midst of being born. Or even before that.

We all die. And we don't die when we expect to die or after our dreams have all come true or when we've finally made it in the world. No, most of us die in the midst of pretending we'll never die. We die living as if tomorrow were guaranteed and this life will last forever.

When death stalks us or claims a close relative or friend, we weep in shock. How could this happen? It's so out of the blue! Death is never out of the blue. It's always there, right before our eyes. And soon after the tragedy, we go right back to living as if each moment didn't count for eternity.

Life is a gift. Death is a certainty. Dying is one thing we're all capable of, one thing we all ultimately succeed at.

I've often heard people say things like, you've got your whole life in front of you! That's simply not true. We don't have our whole lives ahead of us. We have our whole lives behind us. What we have in front of us is a mystery that could be over at any moment.

*Memento Mori is a Latin phrase meaning, "Remember that you will die."

(I took the top photo at a cemetery in a Naples convent; the one below is from a floor tombstone in a church in Malta.)

Datur Omnibus Mori

I'm back from two weeks in Italy (Rome, Naples) and Malta. You can't visit these places without viewing numerous churches, basilicas, and cathedrals - and even co-cathedrals and pro-cathedrals (really).

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In most of the churches we visited, we walked all over dead people. They're buried under the floors, with their tombstones planted horizontally above them. In Malta, this practice is taken to an extreme, as you can see from the photo above. In Italy and Malta both, those who don't end up under the floor may end up somewhere in the walls, with a tombstone or 3-D marker on the spot.

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Many of these tombstones have depictions of skulls or the grim reaper. It's common to see "D.O.M." on them, which is an abbreviation for a Latin phrase. Depending which authority you consult, the phrase is "Deo Optimo Maximo" ("To God, Who's the Greatest and Best") or "Datur Omnibus Mori" ("It is Given to All to Die"). In this context, the second version fits best.

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The net effect of all this is that you can't go to church without being confronted with death. I find that salutary (pun intended). Every time you go to worship God with your fellow believers, you see grandpa in the floor and uncle in the wall and you're reminded that someday you'll join them.

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"Teach us to number our days aright, that we may gain a heart of wisdom" (Psalm 90.12). Each one of us will die soon - soon in terms of the span of recorded history, even sooner in comparison with the length of eternity. Yet how easily we forget that, especially in our teens and twenties, and think that, invulnerable, we will live forever.

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Even in our country, we used to lay out the dead in the parlors of our homes and then bury them in the cemeteries adjacent to our churches. Every Sunday, you'd see the dead as you came to praise the Immortal. We've gotten away from that. My church is raising millions of dollars right now for expansion, but there's no cemetery in the master plan. And I haven't heard any of my fellow elders suggest we should start burying expired church members in the floor of the auditorium. Maybe it would be good for us if we did.

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In Rome, some Capuchin monks took this message to heart. Five hundred years ago, they started preserving the bones of their deceased "monk brothers" and then began arranging them into various scenes, some rather whimsical. All told, there are now the bones of about 4,000 monks in this relatively small basement. Some would call it macabre. They would call it realistic: a sign posted there says, "What you are, we once were; what we are now, you one day will be."

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"Teach us to number our days aright, that we may gain a heart of wisdom."

Happy Birthday, Dad

Today would have been my dad's 85th birthday. He died almost 5 years ago.

He and Mom adopted me when he was 35, which probably explains why he always seemed to be tired. But he meant well, and I believe he did the best he knew how to do at raising me and my sister.

He was a child of the Depression, and that steered his approach to finances all his life. He and Mom were known for their frugality (Christmas trees should never cost more than $5, for example), and they always lived below their means. He did like to travel, though, and he took me on my first "big" trips, to D.C., Yellowstone, and Glacier National Park. Cheapness and a love of travel are at least two of his traits that rubbed off on me.

During World War II, he protected Alaska from attack. I guess he did OK, because Alaska is still there. I suspect the greatest hazard was terminal boredom, but he survived.

After nearly 80 years of spiritual apathy, he came to faith in Christ, a year or two before he died. I'd been praying for him for 30 years.

I'll see him again.

Between Friday and Sunday

Tombs and Wombs

While at the concert last week of Bach’s St. John Passion, I had a new thought – new for me, that is. The text from the book of John says that Jesus was laid in “a new tomb, in which no one had ever been laid” (John 19.41). For some reason, it struck me that this is a parallel with his birth. He was born from a virgin womb, and He was buried in (and rose from) a virgin tomb. If there’s any theological significance to this, I haven’t yet figured out what it is. But it is a nice symmetry.


News You May Have Missed: Ahmadinejad, The Press, and Easter

When the 15 British sailors were released from Iran a couple days ago, the press uniformly reported that President Ahmadinejad said he was releasing his prisoners as an Easter gift. For example, the New York Times ran this AP version: "Irans's president, Mahmoud Ahmadinejad, said he had pardoned the sailors as an Easter holiday gift to the British people.”

That caught my eye, because I wouldn’t expect the president of Iran to care much about a Christian holiday.

What did he really say? MSNBC ran a longer version of his remarks, and they’re informative:

“Ahmadinejad said he had pardoned the sailors as a gift to the British people and to mark the birthday of Islam's Prophet Muhammed and Easter. On the occasion of the birthday of the great prophet (Muhammad) ... and for the occasion of the passing of Christ, I say the Islamic Republic government and the Iranian people -- with all powers and legal right to put the soldiers on trial -- forgave those 15."

“The occasion of the passing of Christ.” Would somebody please tell the press that the death of Jesus isn’t the definition of Easter?

(More about this story at GetReligion.org.)

Your Jesus is Dead.

Erzähle der Welt und dem Himmel die Not:
Dein Jesus ist tot!

Tell earth and heaven the sad news:
Your Jesus is dead!

-- From Bach's St. John Passion